How can having depressed shoulder blades cause pain?

The top of the shoulder blade (scapula) should sit roughly at the second or third thoracic vertebra. I often see scapulae that sit lower than this. When this occurs, the upper trapezius is typically too long and/or weak to hold up the scapula.

I see this problem in nearly everyone with shoulder or elbow pain. Shoulder blades sitting too low (depressed) set the stage for inadequate elevation of the scapula during overhead motions, compromising shoulder muscles and other tissues.

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